U.S. patent number 8,326,455 [Application Number 12/953,754] was granted by the patent office on 2012-12-04 for methods for point-of-use medication control.
Invention is credited to Lawrence A. Dunn.
United States Patent |
8,326,455 |
Dunn |
December 4, 2012 |
Methods for point-of-use medication control
Abstract
Methods for controlling the dispensing of medication are
provided. The method can include holding at least one medication
within a dispenser and alerting a patient that a dose of medication
is to be taken or an optional dose of medication is available to be
taken. Once the patient is present for receiving a does of
medication, the identification of the patient can be confirmed.
Upon confirmation of the identification, a dose of medication for
the patient can then be dispensed and removal of medication from
dispenser can be confirmed. The method can also include providing a
location determination device with the dispenser to permit locating
the dispenser.
Inventors: |
Dunn; Lawrence A. (Durham,
NC) |
Family
ID: |
38225570 |
Appl.
No.: |
12/953,754 |
Filed: |
November 24, 2010 |
Prior Publication Data
|
|
|
|
Document
Identifier |
Publication Date |
|
US 20110125317 A1 |
May 26, 2011 |
|
Related U.S. Patent Documents
|
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
Issue Date |
|
|
11649471 |
Jan 4, 2007 |
7885725 |
|
|
|
60756372 |
Jan 5, 2006 |
|
|
|
|
Current U.S.
Class: |
700/237; 700/244;
700/241; 700/236; 221/278; 221/211 |
Current CPC
Class: |
G07F
9/02 (20130101); G07F 9/026 (20130101); G16H
20/13 (20180101); G16H 40/67 (20180101) |
Current International
Class: |
G06F
17/00 (20060101) |
Field of
Search: |
;221/211,278
;700/236,237,241,244 |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
"Monitored Automatic Medication Dispenser MD.2 from e-pill,"
http://www.age-in-place.com/md2.html (Downloaded from the internet
on Nov. 17, 2005). cited by other .
"e-pill Multi-Alarm: Easy-to-Program Medication Reminder,"
http://www.age-in-Place.com/multialarm.html (Downloaded from the
internet on Nov. 17, 2005). cited by other .
"Automatic Pill Dispenser: e-pill Med-Time `Electronic Pill Box`
Automatic Medication Dispenser & Reminder,"
http://www.age-in-place.com/medtime.html (Downloaded from the
internet on Nov. 17, 2005). cited by other .
"MD.2 Personal Medication System," Interactive Medical
Developments, L.C., http://www.imd2.com (Downloaded from the
internet on Nov. 17, 2005). cited by other .
"Pyxis Corporation's Positive ID Assures Secure Access to
Medications,"Cardinal
Health,http://www.cardinal.com/content/news/060198.sub.--65988.asp
(Downloaded from the intemet on Nov. 17, 2005). cited by other
.
"Hendricks Regional Health Adds State-of-theArt Medication-Use
Technology to Increase Patient Safety," Omnicell,
http://www.omnicell.com/news.sub.--events/release.sub.--display.asp?p.=23-
8 (Downloaded from the Internet on Nov. 17, 2005). cited by other
.
"Fingerprint Sensors Enhance Accuracy in User-Authentication
Application," Medical Devicelink,
http://www.devicelink.com/emdm/archive/03/11/006.html (Downloaded
from the Internet on Nov. 18, 2005). cited by other .
"Authentec: The Power of Touch--Electronic Fingerprint Sensor,"
Authentec main website, http://www.authentec.com (downloaded from
the intemet on Nov. 18, 2005). cited by other .
Brian Robinson, "VA Improves Telehealth Access: Slimmer Equipment,
Web Access Make a Better Case for Home Care," Technology Briefing
(Jan. 6, 2002). cited by other .
e-pill.RTM. website pages, http://www.epill.com/ (downloaded from
the internet between Apr. 24, 2012 and May 1, 2012). cited by other
.
MedMinder.TM. website pages, http://www.medminder.com/ (downloaded
from the internet on Apr. 13, 2012). cited by other .
MedSignals website pages, http://www.medsignals.com/ (downloaded
from the internet on Apr. 24, 2012). cited by other .
TabSafe website pages, http://www.tabsafe.com/ (downloaded from the
internet on Apr. 24, 2012). cited by other .
Vitality.TM. wesite pages, http://www.vitality.net/index.html
(downloaded from the internet on Apr. 13, 2012). cited by other
.
e-pill.RTM. product materials and brochures, (downloaded from the
internet on May 1, 2012). cited by other .
MedCenter.TM. "Recording your Minder, The Talking Personal
Recording Alarm Clock", (downloaded from the internet on May 1,
2012). cited by other .
Timex Healthcare Medication Manager Instruction Manual, (downloaded
from the internet on May 1, 2012). cited by other .
Casio.RTM. User's Guide TMR-200, (downloaded from the intemet on
May 1, 2012). cited by other .
Interactive Medical Developments, L.C., "MD.2 Users Manual", Dec.
1, 2005. cited by other.
|
Primary Examiner: Waggoner; Timothy
Attorney, Agent or Firm: Jenkins, Wilson, Taylor & Hunt,
P.A.
Parent Case Text
RELATED APPLICATION
This application is a divisional of and claims priority benefits to
U.S. patent application Ser. No. 11/649,471 filed Jan. 4, 2007, now
U.S. Pat. No. 7,885,725 which claims the benefit of U.S.
Provisional Patent Application Ser. No. 60/756,372, filed Jan. 5,
2006, the entire contents of which are both hereby incorporated by
reference herein.
Claims
What is claimed is:
1. A method for controlling dispensing of medication, the method
comprising: (a) holding at least one medication within a dispenser,
the dispenser device comprising: (i) a sealable pill magazine; (ii)
a dispensing well in communication with the pill magazine, the
dispensing well having an opening therein; (iii) a shutter movably
positionable over the opening of the dispensing well to securely
close the dispensing well; and (iv) a vacuum mechanism configured
to enter through the opening of the dispensing well; (b) alerting a
patient that a dose of medication is to be taken or an optional
dose of medication is available to be taken; (c) confirming
identification of the patient; (d) dispensing a dose of medication
for the patient from the dispenser; (e) confirming removal of
medication from dispenser; and (f) providing a location
determination device with the dispenser to permit locating the
dispenser.
2. The method according to claim 1, further comprising locating the
dispenser via the location determination device upon notification
of misplacement of the dispenser.
3. The method according to claim 1, further comprising
communicating information between the dispenser and a remote
location about dispensing of the medication.
4. The method according to claim 3, wherein the remote location
comprises a central data store and communicating information
between the dispenser and the remote location comprises reporting
status of the dispenser to the central data store.
5. The method according to claim 4, wherein communicating
information between the dispenser and the remote location comprises
the dispenser accepting new dispensing instructions from the
central data store.
6. The method according to claim 4, wherein communicating
information between the dispenser and the remote location comprises
providing secure access to the stored information and instructions
on the central data store to appropriate doctors and pharmacies via
an internet service provider.
7. The method according to claim 1, wherein alerting a patient that
a dose of medication is to be taken or an optional dose of
medication is available to be taken comprises emitting at least one
of an audio or visual signal indicating that the dose of medication
is ready to be taken.
8. The method according to claim 7, further comprising instructing
the dispenser that the signal has been received through a response
mechanism actuatable by the patient.
9. The method according to claim 1, wherein confirming
identification of the patient comprises verifying the identity of
the patient through a biometric identification device.
10. The method according to claim 9, wherein the biometric
identification device comprises a biometric identification
fingerprint system.
11. The method according to claim 1, further comprising instructing
the dispenser to transmit an emergency message to an appropriate
emergency response facility upon actuation of emergency assistance
mechanism.
12. The method according to claim 1, further comprising moving the
shutter between an open position in which access through the
opening of the dispensing well is permitted and a closed position
in which the opening of the dispensing well is closed.
13. The method according to claim 12, further comprising vibrating
a vibrator positioned against the pill magazine.
14. The method according to claim 1, further comprising a tilt
sensor disposed within the outer housing.
15. The method according to claim 1, further comprising disabling
functionality of the dispenser based upon a predetermined
criteria.
16. The method according to claim 15, wherein alerting a patient
that a dose of medication is to be taken or an optional dose of
medication is available to be taken comprises emitting at least one
of an audio or visual signal indicating that the dose of medication
is ready to be taken.
17. The method according to claim 15, further comprising locating
the dispenser via the location determination device upon
notification of misplacement of the dispenser.
18. The method according to claim 15, further comprising
communicating information between the dispenser and a remote
location about dispensing of the medication.
19. The method according to claim 15, wherein confirming
identification of the patient comprises verifying the identity of
the patient through a biometric identification device.
20. The method according to claim 15, further comprising
instructing the dispenser to transmit an emergency message to an
appropriate emergency response facility upon actuation of emergency
assistance mechanism.
Description
TECHNICAL FIELD
The subject matter described herein relates generally to systems
and methods for medication compliance. More particular, the subject
matter disclosed herein relates to devices, systems and methods for
dispensing medication to an intended patient at predetermined and
appropriate times in an outpatient setting to increase the
likelihood of proper medication management of a patient after
leaving the direct care of a doctor or health
provider/professional.
BACKGROUND
The rate of compliance with medication regimens in outpatient
settings is generally regarded as poor. Even under the watchful eye
of doctors, studies have shown that trained professionals working
in a controlled setting make significant errors in the delivery of
medication to patients. Compliance with such medication regimens
have been shown to be worse after the patient leaves the hospital
and the medication management is required to be performed by the
patient or some other untrained family member. For example, studies
have shown that patients directed to take a single medication once
per day have only succeeded about 70% of the time. Studies have
further shown that, when three doses per day are required,
compliance with such medication regimens falls to about 50%.
Further, such studies show that compliance and compliance failures
for such medication regimens do not correlate with social,
economic, or educational variables.
Failure to comply with medication regimens prescribed by doctors
can have severe consequences. For example, in the outpatient
setting, a patient's recovery can be slowed and progress toward
recovery can be minimized by the patient's failure to follow the
prescribed medication regimen provided by a trained professional.
Such lack of compliance can help in the development of drug
resistant strains of bacteria and viruses. For example,
tuberculosis has developed certain drug resistant strains in Africa
due to the fact that rural patients have begun lengthy medication
regimens that required multiple doses but fail to follow through
and complete these regimens. Thereby, the tuberculosis has been
allowed to persist in a form that has become resistant to the
treatment being used. Such drug resistance strains could be
minimized if the patients were able to properly follow through with
their medication regimens.
A further concern applies to certain classes of medication that are
prone to abuse. For example, certain narcotics and anxiety reducing
medications are known to be addictive. For such medications, a
patient will often begin to take increasing amounts of the
medication at more frequent intervals that do not comply with the
prescribed regimen set forth for the use of the drug. The
controlling of dosing for these medications in the outpatient
setting is so notoriously difficult that many physicians have
simply begun to refuse to prescribe them.
Concerns about the diversion of a medication from the patient to
other individuals have reduced the outpatient prescription of such
drugs. For example, medications such as Oxycontin have addictive
qualities and also have street value as a recreational drug. Often,
people who are prescribed such a drug end up selling it to users
who consume it recreationally. This concern is so great for
Oxycontin that some state legislatures have considered banning its
use.
In the examples provided above, drugs that were once valuable to
society have lost part of their effectiveness through their misuse
in one way or another. Therefore, in light of the above, a need
exists for a system that allows outpatient medication to be
dispensed in a secured, controlled, and monitored fashion to more
effectively manage and organize the care given to a patient.
SUMMARY
In accordance with this disclosure, novel devices, systems and
methods for point-of-use medication control in outpatient settings
are provided.
The present disclosure provides devices, systems and methods for
point-of-use medication control that can employ single dose
distribution and dispensing at predetermined and appropriate times
through patient awareness and identification as well as through
compliance confirmation. This and other purposes as may become
apparent from the present disclosure can be achieved, in whole or
in part, by the presently disclosed subject matter when taken in
connection with the accompanying drawings as best described herein
below.
BRIEF DESCRIPTION OF THE DRAWINGS
A full and enabling disclosure of the present subject matter
including the best mode thereof to one of ordinary skill in the art
is set forth more particularly in the remainder of the
specification, including references to the accompanying Figures in
which:
FIG. 1 illustrates a schematic of an embodiment of a system for a
point-of-use medication control according to the present subject
matter;
FIG. 2 illustrates a schematic of an embodiment of a dispenser
device used within the system according to FIG. 1;
FIGS. 3A-3C illustrate perspective views of components of an
embodiment of a system for a point-of-use medication control
according to the present subject matter;
FIG. 4 illustrates a backside perspective view of a component of
the embodiment of the system for a point-of-use medication control
according to FIGS. 3A-3C;
FIGS. 5A-5E illustrate interactive screen display windows used for
user interaction with a controller of an embodiment of a system for
a point-of-use medication control according to the present subject
matter;
FIG. 6 illustrates a schematic representation of embodiments of
possible data tables used within a database of an embodiment of a
system for a point-of-use medication control according to the
present subject matter;
FIG. 7 illustrates a schematic representation of interactions
between the data tables of FIG. 6;
FIG. 8 illustrates a screen of a database that employs the data
tables of FIG. 6;
FIG. 9 illustrates a screen of a database that employs the data
tables of FIG. 6;
FIG. 10 illustrates a screen of a database that employs the data
tables of FIG. 6;
FIG. 11 illustrates a screen of a database that employs the data
tables of FIG. 6;
FIG. 12 illustrates a screen of a database that employs the data
tables of FIG. 6;
FIG. 13 illustrates a screen of a database that employs the data
tables of FIG. 6;
FIG. 14 illustrates an interactive screen display window used for
an internet web browser interface for a database of an embodiment
of a system for a point-of-use medication control according to the
present subject matter;
FIG. 15 illustrates an interactive screen display window used for
an internet web browser interface for a database of an embodiment
of a system for a point-of-use medication control according to the
present subject matter;
FIG. 16 illustrates an interactive screen display window used for
an internet web browser interface for a database of an embodiment
of a system for a point-of-use medication control according to the
present subject matter;
FIG. 17 illustrates an interactive screen display window used for
an internet web browser interface for a database of an embodiment
of a system for a point-of-use medication control according to the
present subject matter;
FIG. 18 illustrates an interactive screen display window used for
an internet web browser interface for a database of an embodiment
of a system for a point-of-use medication control according to the
present subject matter;
FIG. 19 illustrates an interactive screen display window used for
an internet web browser interface for a database of an embodiment
of a system for a point-of-use medication control according to the
present subject matter;
FIG. 20 illustrates an interactive screen display window used for
an internet web browser interface for a database of an embodiment
of a system for a point-of-use medication control according to the
present subject matter;
FIG. 21 illustrates an interactive screen display window used for
an internet web browser interface for a database of an embodiment
of a system for a point-of-use medication control according to the
present subject matter;
FIG. 22 illustrates an interactive screen display window used for
an internet web browser interface for a database of an embodiment
of a system for a point-of-use medication control according to the
present subject matter; and
FIG. 23 illustrates an interactive screen display window used for
an internet web browser interface for a database of an embodiment
of a system for a point-of-use medication control according to the
present subject matter.
DETAILED DESCRIPTION
Reference will now be made in detail to presently preferred
embodiments of the present subject matter, one or more examples of
which are shown in the Figures. Each example is provided to explain
the subject matter and not as a limitation. In fact, features
illustrated or described as part of one embodiment can be used in
another embodiment to yield still another embodiment. It is
intended that the present subject matter cover such modifications
and variations.
FIG. 1 illustrates a medication dispensation control system,
generally designated as 10. System 10 includes a dispenser,
generally designated as 20, that is capable of holding and
delivering at least one dose of medication to a patient in an
outpatient setting. Dispenser 20 can have an outer housing 22 that
encloses the operational components of a portion of system 10
within dispenser 20 and prevents tampering and unauthorized removal
of medication from dispenser 20. In use, dispenser 20 could be used
to distribute units of medications in the form of tablets, pills or
capsules at predetermined times to specified and identified
individuals.
System 10 can also include a controller, generally designated as
30. Dispenser housing 22 can enclose controller 30, which is
operably connected to operable components of dispenser 20.
Controller 30 can automatically operate dispenser 20 to provide a
dose of medication to the patient at the appropriate or
predetermined time. For example, controller 30 can be programmable
with a medication dispensing program which includes a data store
comprising the predetermined time to operate dispenser 20 and the
name of the at least one medication. The data store of the
medication dispensing program can also comprise patient data and a
patient compliance schedule. Patient data can include the first and
last name of the patient, the age of the patient, medical history
information, or the like. Biometric information, such as
fingerprint data or the like can also be considered patient
data.
The data store of the medication dispensing program on controller
30 can also comprise caregiver data. The caregiver can be anyone
such as a family member or nurse who is charged with taking care of
the patient. In such cases where a caregiver is necessary to
administer the medication to the patient, the caregiver can be
allowed to engage system 10 to receive the medication to be
administered to the patient. Caregiver data can include first and
last name of the caregiver, contact information of the caregiver,
or the like. Biometric information, such as fingerprint data or the
like can also be considered caregiver data. Through such
information, the caregiver can gain access to the medication to be
administered to the patient.
The data store of the medication dispensing program on controller
30 can also comprise compliance notification data. Compliance
notification data can include the frequency of timely compliance by
the patient, data on the dates and times at which compliance
occurs, or the like. The data store of the medication dispensing
program on controller 30 can further comprise pharmacy data,
physician data, insurance data and emergency contact data.
Controller 30 can include devices that emit any suitable type of
signal to indicate dispenser 20 is ready to provide a dose of
medication for the patient to receive. For example, a display
screen, such as an interactive user interface display screen 32 can
be provided that can alert the patient that a dose of medication is
ready to be dispensed. In the embodiment shown in FIG. 1, a simple
display saying that the dispenser is ready to dispense is shown on
display screen 32. The display also shows a user interface 34 on
display screen 32 with which the patient can interact to
acknowledge receipt of the signal. The user interface 34 can be a
response button 36 in the form of a graphic display button that the
user activates by touching the screen at the display location of
the graphic display button. By activating this button 36, the
patient acknowledges receipt of the signal and the dispensing can
begin. Other response mechanisms can be provided including other
graphic display buttons. For example, button 38 can be provided
that allows the patient to skip the dispensing of the dose of
medication.
Besides the display 32, a speaker 40 can be provided to provide an
audible signal that would be emitted by the speaker 40. Speaker 40
can be internally contained with outer housing 22 or it can be
external. In this manner, a patient who cannot view display 32 can
still be notified of the availability of the dose medication. Once
the patient has acknowledged receipt then the audible signal can
end as well. Other response mechanisms can be provided to allow the
user to acknowledge receipt of the signal that medication is
available for dispensing. For example, a physical button can be
provided that the patient can activate. Further, a lever or switch
can be provided that can be activated by the patient after receipt
of the signal.
To monitor and verify that the dispensing of the drug is to the
correct individual, an identification verification device,
generally designated as 50, can be provided in outer housing 22 of
dispenser 20 and can be connected to controller 30. Identification
verification device 50 can be used to verify that the patient for
whom the medication is to be given is present and ready for
distribution of the medication. In this manner, identification
verification device 50 can be used to verify the identity of the
patient.
The identification verification device 50 can be a biometric
identification device. For example, TruePrint technology based
fingerprint sensors offered by AuthenTec, Inc. of Melbourne, Fla.,
can be used as the fingerprint system 52. Fingerprint system 52 can
include a touch screen 54 that can provide a place for the patient
to place a finger. Fingerprint system 52 can then read the
fingerprint and compare it to stored data to confirm that the
individual trying to receive the doses of medication is in fact the
intended recipient.
Other identification verification devices such as retina scans,
user passwords, voice recognition or the like can be used to verify
the identity of the patient before distribution of the dose of
medication within dispenser 20.
System 10 can further include a communication device 60 that can
also be in operable communication with controller 30. Communication
device 60 can be a wireless communication device. Such an
electronic communication device 60 that operate on a wireless
platform and can include an antenna 62 that transmits signals
through a cellular network 64 to a remote facility, or location 70
that can house a database 72 for use in controlling dispenser 20.
Database 72 can be accessed by the patient's doctor, pharmacy,
and/or administrator of the medication system, as well as the
patient. Through the wireless connection provided by cellular
network 64, controller 30 can communicate through an Internet
Service Provider 66 with the database 72 at the remote facility 70.
Internet Service Provider 66 manages data collection and
distribution to and from database 72 for the users. The users can
include the patient, the patient's doctor and/or pharmacist, and/or
the administrator of the medication system.
Through the Internet 68, appropriate individuals can gain access to
the information provided to and from dispenser 20 to monitor and
control the dosing of the medication. For example, such individuals
or locations can include the patient, the doctor's office, the
pharmacy, or the administration facility, where administrator
resides. Authorized personnel from the doctor's office can gain
access to patient and dispenser information stored on database 72
through a clinician browser 74. Authorized personnel from the
pharmacy can gain access to patient prescription information stored
on database 72 through a pharmacist browser 76. Authorized
personnel from the administration facility can gain access to
clinician, pharmacist, and dispenser information stored on database
72 through an administrator browser 78. Data stored can include
information such as predetermined times to operate dispenser 20.
The data can also include the name of the medication being
distributed, the patient's data, the patient's compliance schedule,
caregiver data, and compliance notification data as well as
pharmacy data, physician data, insurance data, and emergency
contact data. Further, such information can be provided on a data
store connected to controller 30 within dispenser 20 itself.
Controller 30 can be programmable to connect to a predetermined
Internet Service Provider 66 through electronic communication
device 60 and cellular network 64 in order to transmit the
patient's data and obtain a patient registration. Controller 30 can
also be programmable to connect to Internet Service Provider 66
through electronic communication device 60 in order to transmit the
compliance schedule and compliance notification data from database
72. Controller 30 can also be programmable to connect to Internet
Service Provider 66 through communication device 60 in order to
transmit or receive the pharmacy data, physician data, insurance
data, and emergency contact data.
When controller 30 has received instruction that the signal has
been received, controller 30 can transmit a compliance notification
to Internet Service Provider 66 to be sent on to the physician,
pharmacist, or administrator. Alternatively, the compliance
notification can be sent to database 72 where the physician,
pharmacist or administrator can access the notice of compliance.
Similarly, if the recipient does not acknowledge the signal and the
signal goes on for a predetermined time, controller 30 can send a
signal to Internet Service Provider 66 to transmit a non-compliance
notification that then can be forwarded onto the physician,
pharmacist, or administrator as well as stored in the database as
needed.
The user can use display screen 32 to communicate with controller
30 to order a refill of the medication or to order a new dispenser
20 containing the medication when the system is connected to the
predetermined Internet Service Provider 66. In this manner, the
user can take dispenser 20 back to the pharmacy to have it refilled
or to pick up a new dispenser 20 which can be taken back and used
by the patient. The interchangeable dispensers 20 provide a way to
easily monitor the drugs that are placed into each dispenser 20 by
the pharmacist. The pharmacist can ensure that the correct
information is downloaded into controller 30 within the appropriate
dispenser 20 for the appropriate patient before the patient picks
that dispenser 20 up from the pharmacy or doctor's office.
Controller 30 can also be programmable to update and transmit the
caregiver data and compliance notification data to the database or
Internet Service Provider 66 and/or the clinician browser 74,
pharmacist browser 76, or administrator browser 78 when the system
is connected to Internet Service Provider 66. Controller 30 can
automatically connect and send such information as needed or
desired. Further, communication device 60 can receive notices from
the predetermined Internet Service Provider 66 when the system is
connected to the predetermined Internet Service Provider 66.
Controller 30 can be programmable to receive and use notices as
necessary to better manage dispenser 20. Similarly, controller 30
can be programmable to access and search databases provided by
Internet Service Provider 66.
System 10 can also include a location determination device (not
specifically shown) such as an integrated global positioning system
("GPS") receiver that can be contained within outer housing 22 of
dispenser 20. For example, a location determination device can be
integrated into controller 30. Such a device permits the
whereabouts of dispenser 20 to be easily determined. If someone
tries to steal dispenser 20 or dispenser 20 is misplaced, the
patient can contact the administrator who can track down the
location of dispenser 20. For example, the administrator can use
tracking software and communication systems of a GPS system used
within dispenser 20 for determining the location of that dispenser
20. In this manner, theft of the dispenser can be minimized, and,
hopefully, the chances of the perpetrator being caught and
prosecuted can be increased.
System 10 can also include a telephone modem within dispenser 20
that allows it to be hooked up to a telephone line to call for
emergency assistance, if needed. Dispenser 20 can include an
emergency assistance button 24 that can be actuated to cause
controller 30 to dial an emergency telephone number. Dispenser 20
can also include a dispensing door 26 which can be used to permit
access into dispenser 20 to remove a dose of medication. Dispenser
20 can also include a microphone 42 to allow for the patient to
communicate with an emergency facility, which is contacted by
controller 30.
Dispenser 20 can further include a lockout for disabling
functionality of the system based upon predetermined criteria. Such
a lockout can be in furtherance to identification verification
device 50, which can also be used to prevent unwanted access to the
medication contained in dispenser 20. However, the lockout can help
to prevent overdosing of the patient or dosing of the patient when
the patient is not in a condition to receive such medication. For
example, the lockout can include a breath sensor 46 for determining
a breath alcohol level. The breath alcohol level can then be
compared to predetermined criteria that can include a maximum
breath alcohol level that would be allowable for dispensing of the
dose of medication from dispenser 20. The lockout can also include
an interactive cognitive test on predetermined criteria that can
include a minimum cognitive level based on the results of the test
to allow dispensation of the dose of medication from dispenser 20.
The interactive cognitive test can be performed through a display
on the interactive display screen 32. In this manner, overdosing
can be prevented as well as dosing of a patient who is too heavily
medicated or disoriented to take the medication. Health hazards
relating to the mixing of medications or alcohol with medications
can be prevented. Based on the results from the lockout, an
emergency contact, the doctor's office, pharmacy or a caregiver of
the patient can be alerted that the patient is in a state that
requires attention.
FIG. 2 illustrates a schematic internal view of the dispenser 20.
Dispenser 20 includes a pill magazine 100 which can be filled at a
pharmacy through a fill door 102. Fill door 102 can be locked to
prevent access to the store of pills 104 within pill magazine 100.
A tamper switch 106 can also be provided to monitor and record the
opening of fill door 102 or other tampering that can occur to fill
door 102 once dispenser 20 has left the pharmacy.
Pill magazine 100 can be defined by an inner wall 108 and an outer
wall 110 and two side walls. Further, a slanting base surface wall
112 can extend within the dispenser 20 from the outer wall 110
downward to a bottom wall 110B forming an angle .alpha. with bottom
wall 110B. Inner wall 108 does not extend to base surface wall 112,
thereby leaving an opening for pills to slide downward into a
dispensing well 114.
Outer wall 110 and/or bottom wall 110B can be internal walls that
reside within outer housing 22 (shown in FIG. 1). Alternatively,
outer wall 110 and/or bottom wall 110B can be external walls which
help to form outer housing 22 of dispenser 20.
At a filling location such as a pharmacy, when fill door 102 is
opened and pills 104 are placed into pill magazine 100, pills 104
flow downward under gravitational force to the base surface wall
112 and slide down its sloped surface which slopes downward from
external wall 110 at angle .alpha.. The pills 104 can slide into
dispensing well 114 underneath end 116 of inner wall 108. A
dispensing well wall 118 extends upward and parallel to inner wall
108 of pill magazine 100 to help define an opening in dispensing
well 114. Dispensing well wall 118 permits only a small number of
the pills from pill magazine 100 fill the dispensing well 114 at
any given time.
Dispensing well wall 118 can also include a slanted base wall 120
that slopes upward from the base surface wall 112 of pill magazine
100. A vibrator 122 can be used and positioned below base surface
wall 112 to add vibration to base surface wall 112, thereby
agitating pills residing on base surface wall 112. This vibration
can cause pills 104 to fall or move down the sloped surface of the
base surface wall into dispensing well 114. Vibrator 122 can be in
communication with an optical detector 124 which can be placed
along dispensing well wall 118 or base surface wall 120. Optical
detector 124 can detect whether any pills reside in dispensing well
114. If optical sensor 124 does not detect the presence of pills
104 within dispensing well 114 then vibrator 122 can be activated
to cause any pills residing in pill magazine 100 to slide down the
slope surface of base surface wall 112. Optical detector 124 can be
any conventional optical sensor known in the art.
Once it is determined that pills 104 reside in dispensing well 114,
a vacuum pick up 126 can be actuated to pickup a pill 104 for
delivery to dispensing door 26 of dispenser 20. The opening of
dispensing well 114 can be opened and closed by motorized shutter
128, which can provide a slanted surface 130. When motorized
shutter 128 is in a closed position as shown in FIG. 2, pills 104
within pill magazine 100 and dispensing well 114 are prevented from
removal from dispenser 20.
A tilt sensor 132 can be provided which is activated when dispenser
20 is tilted to prevent its operation while inverted or shaken.
Tilt sensor 132 can be in communication with controller 30 (see
FIG. 1). Such information as whether dispenser 20 is shaken or
tilted can be sent from tilt sensor 132 to controller 30.
Controller 30 can then render dispenser 20 inoperable and it can
also forward a message to Internet Service Provider 66 and onto the
clinician browser 74, pharmacist browser 76, or administrator
browser 78 (see FIG. 1). Tilt sensor 132 can be a conventional
equilibrium sensor. Tilt sensor 132 can also be configured to shut
down dispensing operations directly if tilting or shaking is
detected.
Dispenser 20 also can include, as noted above, a vacuum pickup 126,
which can be a part of a vacuum mechanism 134 for removal of at
least one pill from dispensing well 114 for delivery to dispensing
door 26 of dispenser 20. Vacuum mechanism 134 can include a vacuum
pump 136 that creates a negative pressure that can be used to pick
up a pill 104 from dispensing well 114. Vacuum mechanism 134 can
also include a vacuum tube 138 that is connected to vacuum pump 136
on one end 140 such that the negative pressure created within
vacuum pump 136 creates a vacuum through vacuum tube 138. Vacuum
pickup 126 can be secured on the other end 142 of vacuum tube 138.
Vacuum pickup 126 as well as vacuum tube 138 can be extended into
dispensing well 114 to retrieve a pill therefrom.
Vacuum pickup 126 can include a vacuum cup 144 disposed at its end
distal from vacuum tube 138. Vacuum pickup 126 can be raised and
lowered by a step motor 146. In the embodiment shown, step motor
146 can rotate a belt 148 which is secured to the vacuum pickup
126. By running step motor 146 in one direction, vacuum pickup 126
is lowered. By running step motor 146 in a reverse direction, the
rotation of belt 148 can be reversed and vacuum pickup 126 can be
raised.
A vacuum sensor 150 can be in communication with vacuum mechanism
134. Vacuum sensor 150 can detect whether or not a pill is stuck to
the vacuum pickup 126 at vacuum cup 144 thereof. In this manner,
vacuum mechanism 134 determines when a pill is secured to vacuum
pickup 126 so that it can be raised from dispensing well 114 and
ready for delivery to dispensing door 26 of dispenser 20.
In operation, once the patient has acknowledged receipt of the
signal indicating time for the receipt of a dose of medication and
the patient has identified himself or herself to system 10,
dispenser 20 is ready to dispense a dose of medication to the
intended recipient. When a pill 104 is to be dispensed, motorized
shutter 128 can be moved from its closed position as shown in FIG.
2 to an open position (see FIGS. 3A and 3B) to allow vacuum pickup
126 to be lowered into dispensing well 114. As noted above, tilt
sensor 132 can prevent shutter 128 from opening if dispenser 20 is
tilted, inverted or shaken.
Optical sensor 124 can check to determine if any pills 104 are in
position within dispensing well 114 to be picked up by vacuum
pickup 126. If no pills 104 have fallen into dispensing well 114,
vibrator 122 vibrates base surface wall 112 to agitate base surface
wall 112 within pill magazine 100 to cause any pills 104 within
pill magazine 100 to fall down the sloped surface of base surface
wall 112 into position within dispensing well 114. As noted above,
base surface wall 112 can be at an angle .alpha. as measured from
the bottom outer wall 110B that provides enough of a slope to
encourage pills 104 to slide into dispensing well 114.
As vacuum pickup 126 is lowered, vacuum pump 136 creates negative
pressure which creates a vacuum suction through vacuum cup 144 of
the vacuum pickup 126. As vacuum cup 144 comes in contact with a
pill and thereby seizes the pill through vacuum pressure, vacuum
sensor 150 detects that a pill is stuck to vacuum pickup 126. Step
motor 146 can then be run in reverse, such that vacuum pickup 126
is raised out of dispensing well 114.
Optionally, an optical detector 152 can be secured to vacuum pickup
126 to make sure a pill is in position for pickup. Optical detector
152 optically determines if a pill resides within dispensing well
114 that can be picked up through vacuum pickup 126. If no pill is
sensed by the optical detector 152, then vibrator 122 can be run.
Vacuum pickup 126 can be lowered by step motor 146 by rotating belt
148 in a specified direction until optical detector 152 detects a
pill at the pickup. Vacuum pump 136 starts creating a negative
pressure that lifts the pill to vacuum cup 144. Vacuum sensor 150
then detects that a pill is stuck to vacuum pickup 126. If a pill
is detected, vacuum pickup 126 is raised by reversing step motor
146 so that belt 148 raises vacuum pickup 126.
Once vacuum pickup 126 with the pill attached to vacuum cup 144 has
cleared dispensing well 114, motorized shutter 128 can then be
moved into a closed position of the opening in dispensing well 104
as shown in FIG. 2. At this point, the vacuum pump 136 shuts off,
allowing the pill to fall against slanted surface 130 of shutter
128. The pill falls to a removal position 154 at dispensing door 26
of dispenser 20. An optical sensor 156 can be placed in proximity
to removal position 154 to detect that the pill is in place before
allowing access to the pill through dispensing door 26. If no pill
is detected, then the steps of picking up a pill through vacuum
pickup 126 can be repeated until it is recognized that a pill is in
position for removal from dispensing door 26 of dispenser 20.
Vacuum pickup 126 can be recessed slightly into the body of
dispenser 20 to ensure that the pill attached thereto drops freely
when the vacuum is removed.
FIGS. 3A, 3B, and 3C illustrate components of an embodiment of a
system 10, including a dispenser 20 outside of its outer housing
that can be used to enclose the dispenser 20 and the other
components. The components are shown free standing relative to one
another and can be arranged in any known manner that provides
necessary access to any interactive component that the patient must
engage to receive the intended doses of medication. Dispenser 20
can include pill magazine 100, vacuum mechanism 134, and motorized
shutter 128 as well as dispensing well 114. A controller 30 as well
as an identification verification device 50 can also be included as
components of system 10. Further, a location determination device
80 can be included in system 10. As noted above, location
determination device 80 can be a GPS device that can easily be used
to locate the whereabouts of the system 10. Controller 30 can be a
microcomputer such as a personalized digital assistant ("PDA"), for
example, an Ipaq 3635. Controller 30 can also be a computer,
programmable logic controller, or the like. Controller 30 can
operate using any compatible operating system. For example,
controller 30 can operate using Microsoft Pocket PC. Controller 30
can provide a display screen 32 which can be a touch-tone
interactive display. Further, controller 30 can provide physical
buttons 36B which control a cursor on display screen 32 to allow
interaction between the patient-user and the controller 30.
Controller 30 can be in communication with identification
verification device 50 in the embodiment shown. Identification
verification device 50 can be a fingerprint reader 52 which has a
touch screen 54 on which a patient-user can place a finger in order
for the fingerprint reader 52 to read the user's fingerprint.
Controller 30 can also be in communication with the vacuum pump 136
of vacuum mechanism 134 as well as a step motor 160 that is used to
control shutter 128 for opening and closing of shutter 128 to
provide access through the opening in dispensing well 114. Further,
controller 30 can be in communication with step motor 162 (shown in
FIG. 4) used to raise and lower vacuum pick up 126 through a slide
170 to which vacuum cup 164 is attached. Slide 170 rides within a
slot 172 that extends downward into dispensing well 114. Vacuum
sensor 150, which is used to determine the presence of a pill on
vacuum pump 164, also can be in communication with controller
30.
Vacuum mechanism 134 components can be controlled by a separate
vacuum controller 166 as shown in FIGS. 3A-3C and 4 that is in
communication with the controller 30. Such vacuum controller 166
can be a Parallax microcontroller offered by Parallax, Inc., of
Rocklin, Calif. Controller 30 can direct operation of vacuum
mechanism 134 by communicating with vacuum controller 166. In other
embodiments, controller 30 can directly control vacuum mechanism
134 and its components.
Location determination device 80 can be in communication with
controller 30 to pass location information to the controller 30 and
onto a remote facility 70 or Internet Service Provider 66 (See FIG.
1). Further, location determination device 80 can produce a signal
that is independent of controller 30 and communication device 60
that is detectable by an appropriate positioning system such as a
GPS. In such embodiments, the signal from the location
determination device 80 can be picked up by the administrator as
needed.
All components of system 10 can share a common battery power supply
(not shown). All components of system 10 can also communicate with
controller 30 via an RS232 serial interface.
In operation, controller 30 can be preloaded and programmed with
dispensing instructions as to the times of use at the location
where dispenser 20 is filled. Programming and fingerprint template
transmission also can be done remotely. A patient's fingerprint
would only need to be enrolled once for use on multiple units.
Pill magazine 100 of dispenser 20 can store a single type of pill
or capsule therein. Pill magazine 100 can be filled at a pharmacy.
Dispenser 20 can then be secured to prevent access to pill magazine
100 or prevent unauthorized removal of the pill or capsule from
dispenser 20. As described, a fill door (not shown) can be used to
fill pill magazine 100. The fill door can then be locked and a
tamper switch can be used to detect any opening of the fill
door.
Once controller 30 determines it is time to dispense medication to
the patient, a signal can be sent out to notify the patient that it
is time to receive a dose of medication. For example, a visual
signal can be shown on display screen 32 to notify the patient of
availability of the dose of medication. Additionally, or
alternatively, an audible signal through a speaker system (not
shown) can be sent out by controller 30 to alert the patient of the
availability of a dose of medication. The patient can acknowledge
receipt of the signal through use of buttons 36B. Then, the patient
can verify his or her identity through identification verification
device 50. The patient can interact with system 10 via display
screen 32 of controller 30, or through buttons 36B of controller
30, to verify the cognitive level of the patient through cognitive
tests. Additionally, or alternatively, a breath analyzer mechanism
can be provided to discern the alcohol level within the bloodstream
of the patient to ensure no ill effects of mixing the medication
and alcohol will result from allowing dosage to be dispensed to the
patient. Once identification has been verified and any cognitive
tests which can be employed have been fulfilled, controller 30 can
instruct vacuum mechanism 134 to remove a pill or capsule for
distribution to the patient.
At such time, step motor 160 can drawn back shutter 128 such that
dispensing well 114 is opened to allow vacuum pick up 126 to enter
dispensing well 114 to remove a pill or capsule disposed therein as
shown in FIG. 3A. As discussed above, a tilt sensor can be disposed
within the dispenser that identifies when the machine is titled,
inverted, or shaken. In such instances, shutter 128 is placed
immediately into a closed position, if it is not already in that
position, and dispenser 20 is rendered inoperable. Further,
dispenser door 26 can be secured in a shut position to prevent
removal of any pills, and controller 30 can send a signal to the
appropriate locations to notify doctors, pharmacist, or an
administrator of the unauthorized use of dispenser 20.
Once shutter 128 is in an open position as shown in FIG. 3A, vacuum
pick up 126 with its vacuum cup 164 can be inserted into the well
through the motion of step motor 162. In the embodiment shown in
FIG. 4, step motor 162 operates a slide 170 in a conventional
manner, so that slide 170 is moveable along a slot 172. For
example, slide 170 may be attached to a belt (not shown) that can
be rotated in a forward or reverse direction by step motor 162.
Slot 172 can run parallel to dispensing well 114 and can extend
above dispensing well 114 as shown in FIG. 4. Vacuum pickup 126
(shown in FIGS. 3A-3C) can be secured to slide 170 such that vacuum
cup 164 extends downward. Vacuum cup 164 can be a bellow type
vacuum cup, which easily secures to a pill or capsule once placed
under a negative pressure.
Once shutter 128 is moved to its open position through step motor
160, vacuum pickup is lowered by step motor 162 into dispensing
well 114. Controller 30, or alternatively the vacuum controller 166
as shown in FIG. 4, can start vacuum pump 136 to create a negative
pressure through vacuum tube 138. This negative pressure creates a
vacuum through vacuum cup 164 at the end of vacuum pickup 126. As
shown in FIG. 3B, step motor 162 lowers vacuum pickup 126 into
dispensing well 114 such that vacuum cup 164 comes in contact with
a pill or capsule. The negative pressure created by vacuum pump 136
pulls the pill or capsule against vacuum cup 164 such that the pill
or capsule is held by vacuum cup 164 for removal from dispensing
well 114. Controller 30, or vacuum controller 166, verify by vacuum
sensor 150 that vacuum cup 164 has picked up a pill or capsule. At
this point, controller 30, or vacuum controller 166, will then
instruct step motor 162 to raise vacuum pickup 126 out of
dispensing well 114. Vacuum sensor 150 will continue to monitor to
ensure that a pill or capsule is secured by vacuum cup 164. Once
the step motor 162 has raised vacuum pickup 126 to a predetermined
point above dispensing well 114, controller 30, or vacuum
controller 166, will instruct step motor 162 to close shutter 128
as shown in FIG. 3C.
Once vacuum pickup 126 with a pill or capsule attached to vacuum
cup 164 is raised above dispensing well 114, shutter 128 can be
closed. Controller 30, or vacuum controller 166, can turn off
vacuum pump 136. Thereby, the negative pressure is removed from the
vacuum pickup 126 and vacuum cup 164 allows the pill or capsule
secured thereto to drop onto slanted surface 130 of shutter 128.
Slanted surface 130 feeds the pill or capsule into the chute and
down to removal position 154 in front of dispenser door 26 as shown
in FIG. 2. At this point, the pill or capsule is ready for removal
from dispenser 20 by the patient or caregiver.
Once the patient has used a fingerprint touch sensor 52 to confirm
identity and the proper number of pills or capsules are dispensed
and removed, controller 30 records the removal of the pills. After
dispensing medication on timed intervals, controller 30 can
activate a cellular modem 174 of a communication device 60 and
connect to a computer server to exchange data with the Internet
Service Provider server and the database that contains tables for
patients, pharmacists and dispensing units. For example,
information can be exchanged twice a day. Further, information can
be provided to the patient's doctor, pharmacist and the
administrator of the outpatient medication system. In this manner,
data can be exchanged between controller 30 and the computer which
provides access to other necessary parties including the patient
through the cellular modem 174 and antennae 176 of the electronic
communication device 60, both of which are in communication with
controller 30. For example, dose history can be sent to the server
in this manner. Further, if the dispenser is reported as lost, the
server can communicate with the dispenser, while the location
determination device 80 can be used to identify the location of the
dispenser. Once the location is determined, coordinates are then
relayed to the server so the dispenser can be located and
recovered.
Software running on the database server 72 (see FIG. 1) can include
an SQL database to store information about dispensation, enrolled
patients, prescription, and doctors (clinicians). This data is
served out to dispensers as described above and also to authorize
users via Internet 68 using a web browser based interface as
discussed below.
For embodiments which use a graphical user interface that is
displayed on the display screen 32 of the controller 30, the user
interface requires very little input from the patient. As shown in
FIG. 5A, a dispensing window 180 shows a cell 182 for the next
medication dose and a countdown timer cell 184 for that dose. The
top dispense button 186 provides a button to dispense the regularly
scheduled medication dose. However, the regularly schedule dose can
be dispensed through other mechanisms such as by verifying the
identity of the patient through an identification verification
device. The change dose button 180 is not for use by the patient
but is used by the doctor, pharmacist and/or the administrator of
the out-patient medication system. Such a change dose button 188 is
code locked.
Extra doses which can be provided for certain ailments such as
migraines, anxiety, and pain medications, can be handled by the
bottom half of the window 180. A countdown timer cell 190 shows
when an extra dose is or will be available. The second dispenser
button 192 activates the dosing cycle. The quit button 194 can be
provided to end the dispensing program.
A dosing window 200 illustrated in FIG. 5 is provided for pharmacy
access to medication directions. The window 200 is code locked to
prevent access by unauthorized users. The window 200 can be
accessed through the dispensing window 180 after the correct access
code has been entered. Ideally, only the pharmacy has the correct
code to unlock and gain access to the dosing window 200 as shown in
FIG. 5B. The dosing window 200 includes dosing cells 202 that
provide the time identifier 204 for each dose as well as amount
identifier 206 for each dose. In this manner, scheduling time for
each dose can be set by the pharmacist before dispenser 20 leaves
the pharmacy. Approval button 208 is provided to approve the dosing
schedule provided in dosing cells 202 once a scheduled time and
dosage has been entered. A cancel button 210 permits canceling of
the dosing schedule provided in dosing cells 202. In the embodiment
shown, eight dosing cells 202 are provided, but not all of these
cells 202 need to be used. For example, only four doses can be
necessary within a 24 hour period. Thus, only four sets of dosing
cells will need to be used. Further, if necessary, more dosing
cells 202 can be provided.
A change lock code button 212 can be provided to change the lock
code needed to gain access to the dosing window by the pharmacist.
Dosing window 200 does not have to be used by the pharmacist. The
controller of the system can be easily programmed via internet
access to the central database which then can be communicated to
the controller contained within the dispenser in the care of the
patient. In the event that the internet access is unavailable,
dosing window 200 allows programming access to authorized
individuals.
FIG. 5C illustrates dosing ready window 214 that alerts the patient
that the medication is ready to be taken. As noted above in regards
to the dose ready window shown on screen 32 of FIG. 1, the alert
can include the activation of a signal light, tone, vibration, or
voice prompt, thereby providing both visual and audio signals to
alert the patient that a dose is ready. The dose ready window 214
can include a message 216 which alerts the patient to the fact that
a dose is ready. Further, the dose ready window 214 can include an
acknowledgement button 218 that can be activated to acknowledge
receipt of the signal and thereby prompt the user to engage the
finger sensor for activation of the dispenser to provide a dose of
the medication.
Once the signal screen shown in FIG. 5C is acknowledged through
touching of the acknowledgement button 218, a fingerprint reading
window 220 as shown in FIG. 5D can be displayed on display 32 to
prompt the patient to touch a fingerprint sensor for positive
identification of the patient before dispensing of the dose of
medication. The fingerprint sensor provides rapid, reliable, and
easy use and demands very little of the patient. Use of this
identification verification device verifies that the patient is
present at the time the medication is made available. The sensors
on the system further check to see that the dose is picked up.
While the system does not guarantee that the medication goes from
hand to mouth of the patient, it can eliminate every barrier except
willful refusal. If the patient is having trouble then a trouble
button 222 can be provided that serves to trigger a transmission to
a central database that technical support is needed. If finger
reading proves to be a persistent problem, the use of the
fingerprint reader can be bypassed.
Further, the display window can provide a graphical user interface
for changing the lock code as shown in FIG. 5E. A change lock code
window 224 provides the ability of the pharmacist to change the
lock code to prevent unauthorized access to the dosing window which
can be used to alter the dosing schedule and amounts of the dosing
of the medication. Change lock code window 224 can include cells to
enter the old code at cell 226, enter a new code at the new code
cell 228 and confirm the new code at confirmation cell 230. Once
the new code is typed into both the new code cell 228 and the
confirmation cell 230, a change code button 232 can be activated to
change the lock code. Thereby, the old code can be changed to a new
code that controls the access to the dosing window 200. If the code
typed into the new code cell 228 and confirmation code 230 do not
match, the new code must be re-entered in both cells 228, 230. If
the pharmacist does not wish to change the code, a cancel button
234 is provided to close the change code lock window 224.
A server can be used to store a database program that can include
the central database 72 as shown in FIG. 1. For example, an Apple
G5 server available from Apple Computer, Inc., of Cupertino,
Calif., can run OpenBase 9.0, an SQL database program, available
from OpenBase International, Ltd., of Concord, N.H., that can
comprise the central database. An example of a structure of
database 72 is shown in FIGS. 6-13. In particular, an array table
database structure is described, although it is to be understood
that other common forms of databases can be used. Further,
different data can be collected, stored and used within the
Database 72 other than the specific examples shown in FIGS. 6-13.
FIGS. 6-13 are screen shots of a user interface for the database.
Database 72 holds and distributes information on the doctors,
patients, prescriptions, pharmacist, and dispenser units. Within
the screen shots of FIGS. 6-13, different verbiage and words can be
used to describe the same item. For example, dispensers can be
called "trackers" within the screen shots of the particular
embodiment of the database. Also, doctors and/or pharmacist can be
identified by the term "Clinicians." The data interconnections can
be shown within the Figures. The data fields of each table are also
listed. Fields can be added or removed as needed. These changes are
dynamically added to the web interface.
As shown in FIG. 6, an array table can be provided for the
clinician, patient, script, tracker, and EO_PK_ table. These array
tables contain different interconnected information. A clinician
table 236 can include fields for the row ID, time stamp, version,
clinician ID, the first name and last name of the clinician and
patient ID. Similarly, a patient table 238 can have the fields for
the row ID, time stamp, version, clinician ID, the first name and
last name of the patient and patient ID. A script table 240 can
include fields for row ID, time stamp, version, length of time in
days, dose amount, the interval between doses, the medication, the
script ID, the strength level of the medication, and tracker ID for
each dispenser. Script table 240 can include information that would
appear on a prescription or prescription bottle. A tracker table
242 corresponds to the information about the dispenser used by the
patient. The fields of the tracker table 242 include row ID, time
stamp, version, contact time, patient ID, pills remaining, script
ID, tracker ID for each dispenser, and tracker number for each
dispenser. Also, the fields within the tracker table can also
include longitude and latitude of the dispenser provided by a
location determination device, such as a GPS device, within the
dispenser as well as the position time also provided by the
location determination device within the dispenser.
The EO_PK_table 244 includes a row ID, time stamp, version, name,
and primary key information. The EO_PK_Table is a database
programming table used in setting up enterprise objects and primary
keys within the database. The EO_PK_Table can be used to verify
access to different data and is used to assign primary key
attributes to the data entered and aids in placement within the
right tables. The EO_PK_Table is automatically generated by the
database software. The EO_PK_Table may not be necessary depending
on the database software and structure used.
FIG. 7 shows the shared data fields and relationships between the
different tables. For example, information is shared between
clinician table 236 and patient table 238. Patient table 238 also
shares information with tracker table 240 which in turn shares
information with script table 242. In this manner, when certain
information is updated within one of the tables, this information
can be passed on to other associated tables. FIG. 8 shows a screen
shot of an upper level screen which identifies the different tables
by class names and names. FIGS. 9 and 10 show screen shots of data
view information. In particular, FIG. 9 illustrates a clinician
table identifying the clinician by the clinician's ID and his or
her first and last name. FIG. 10 illustrates the top most level of
the database.
FIG. 11 shows a patient table which identifies the patient by his
or her first and last name in the fourth column and patient ID in
the fifth column. The patient table provides a column for clinician
ID to identify the clinician for each patient. Each row contains
specific information for the patient within that row and assigns
each patient a patient ID number displayed in column 6.
FIG. 12 shows a script table which identifies the number of days
for which the medicine in each row is to be taken and the amount of
the dose to be given as well as the interval measured in hours
between doses. The script table also provides the name of the
medication being administered and the strength of the medication.
The script ID is provided as well as the tracker ID which is used
to administer and dispense the associated medication at the
appropriate doses and intervals. The Script table can also include
information on each dose scheduled to be taken within a 24 hour
period instead of relying just on the interval information. This
would allow for greater dosing flexibility. Information regarding
the amount of time that a dose will be available after it is due
can be provided in the Script table. Further, lock out times can be
provided that set the minimum time between doses. For example, if
the lock out time is set at one hour and an optional dose is taken,
then the next dose would not be available until after an hour of
taking that optional dose. Information can also be provided as to
the number of tablets or capsules dispense for each dose or
optional dose requested. Also, the time interval between optional
doses can be provided in the Script table.
FIG. 13 illustrates a tracker table which identifies the row ID and
contact time. The contact time provided is the last time the
dispenser had contact with the database to exchange information.
The tracker table shows the longitude and latitude of each tracker
whose information is contained within the data field. The tracker
table also provides columns for the patient ID for the patient and
the number of pills remaining. The position time in which the
position of each dispenser was last communicated to the database is
also provided. The Script ID links the dispenser to its
prescription. Tracker ID for each dispenser as well as a tracker
number and script ID are provided within the tracker table for each
dispenser. The tracker table can include other information,
including dose history that can have a text summary of the times
and status of each dose. The dose history of optional doses can be
included as well. Further, information as to the time of the last
dose dispensing and time of the last optional dose dispensing can
also be included in the Tracker table or other tables.
As stated above, different database structures can be used with
different information being provided. For example, database
structures such as hierarchical models, network models, relational
models, object models, relational-object models, or the like, can
be used. Further, while database 72 is shown at a remote facility,
database 72 can also be store on the memory of the controller of
the system, if the controller has a large enough capacity.
The clinicians in the form of doctors and/or pharmacist, as well as
the medication system administrator can have access to various
tables within the database. Further, the patient can have limited
access to certain information contained within the database. The
clinicians, doctors, pharmacist, administrators and patients can
have access to the database through an internet web browser
interface as previously discussed. The browser based web interface
can be provided by an Apple G 5 server or in the Apache web server
with web objects acting on the application server. Such internet
web browser interfaces essentially make the central database
accessible to users and to controllers on the dispensers through
the internet.
FIGS. 14 through 23 illustrate embodiments of screen shots which a
user would encounter through an internet web browser interface. In
particular, the screen shots illustrate screens that would be seen
by an administrative level user progressing through the database.
FIG. 14 illustrates a login screen which requires the input of a
user name and password. An assistant box can be checked in order to
identify the person logging into the system as an assistant. Once
the user name and password have been entered, the user can click on
the login button. This login screen provides a secure access to the
data to authorized individuals.
FIG. 15 shows a next level screen that provides access to the
different data tables to the administrator user. In particular,
FIG. 15 shows a web search page that can be accessed from any web
browser. For example, the administrator user can gain access to the
clinician table, the patient table, the script table, or the
tracker table from this page. The administrator user can look up
specific data by using the scroll mechanism provided to look up the
different fields within each data table. For example, the user can
look up information by last name for the clinician or patient by
entering in the specific last name for the clinician or the patient
on which the user is trying to retrieve information. Further, the
user may be able to find information within the script table. For
example, the user can look up information in the field for
medication within the script table. Another example can be to look
up information within the tracker table related to a certain
tracker number by entering the tracker number within the space
provided in the cell for the tracker table. Each field within each
different table can be searched in this manner. The scroll button
beside the field enter cell allows the user to scroll through the
different fields. Further, the relationship of what you are trying
to search can also be changed. Instead of having information pulled
up for the clinician's last name, the "equal sign" can be changed
to a "not equal sign", thereby pulling up information on every
clinician that does not have the specified last name. In this
manner, a variety of ways of searching the different tables within
the database can be accomplished through the web browser.
Once in the data table, links can be followed to other related
tables. At each level, data editing is possible. Different levels
of access are provided for each type of user. Doctors can only see
their own patients listed. Similarly, pharmacies would only see
information on their customers listed. Doctors would be allowed to
modify their own patients dosing schedule but no add patients or
prescriptions. Similarly, pharmacies would be able to add
prescriptions but not modify them. If dispensing units are
distributed from a central location, only administrators would need
to add patients, clinicians, or dispensers to the database.
Privileges to add or modify data entries could be assigned to fit
individuals. FIGS. 16 through 23 illustrate different information
that could be edited within the different tables by an
administrative user.
No screen for controller to server communications is illustrated
since these communications occur using machine-to-machine
protocols. Simple object access protocol ("SOAP") calls are used to
exchange XML packets between the dispensers and the database
server. Contacts are initiated by the controllers of the dispensers
when needed or at timed intervals. The controllers transmit their
status of the dispensers and can accept new programming or data
(including fingerprint templates for new users). As is evident from
the screen shot of the dispensers (trackers data) in FIG. 21,
position information is also transmitted. This would allow recovery
of lost or stolen units.
The embodiments of the present disclosure shown in the drawings and
described above are exemplary of numerous embodiments that can be
made within the scope of the following claims. It is contemplated
that the configurations for the devices, systems and methods for
point of use medication control in the out-patient setting can
comprise numerous configurations other then those specifically
disclosed. Thus, it is intended that the scope of the patent
issuing herefrom will only be limited by the scope of the pending
claims.
* * * * *
References